Toxic shock syndrome is an uncommon life-threatening disease wherein bacterial toxins are the main etiologic factor.
The bacterial toxins that influence this disease are released by Staphylococcus aureus. These bacteria are a part of the normal bacterial flora of the skin. When the patient didn’t develop any defense mechanism or anti-toxin antibodies against the released toxins, this will result in toxic shock syndrome.
It is sometimes confused with another illness called Streptococcal toxic shock syndrome. On the other hand, this disease is caused by toxins released by Streptococcus pyogenes.
Signs and Symptoms
According to the Centers for Disease Control and Prevention (CDC), the signs and symptoms of toxic shock syndrome include an abrupt onset of a high fever, (at least 38.9 oC), diarrhea, low blood pressure, muscle pains, and vomiting.
Low blood pressure, or hypotension, may result in either lightheadedness or fainting. The patient also experiences erythematous macular rashes generally present on the main trunk of the body and the extremities. The individual also observes that the skin on the palm of her hands and soles of her feet are being shed off at a faster rate. The peeling of the skin is usually observed one to two weeks after the onset of toxic shock syndrome.
Presence of bloodshot eyes and redness inside of the mouth may also be noticed. In women, redness of the vagina may also be present because of the increased blood flow in this area.
Moreover, three or more of the following body structures, organs, or systems are affected. These organs include: the liver, kidney, stomach (See: Stomach cancer symptoms), intestines, and mucous membranes. The circulatory and central nervous systems may also be affected.
Diagnosis of the Disease
Aside from the presence of signs and symptoms, a definitive diagnosis can be concluded if no other bacteria or viruses are involved in the disease other than Staphylococcus aureus. In addition, the presence of at least three signs and symptoms and involvement of previously mentioned bacteria increase the probability that the disease is present.
Existence of Staphylococcus aureus in the body can be evaluated using diagnostic tests such as blood examinations and a blood culture. Increased amounts of urea and creatinine urine assessments greatly increase the likelihood that the individual has toxic shock syndrome.
However, if all the signs and symptoms are manifested accompanied by the sole presence of Staphylococcus aureus, the existence of the disease is confirmed.
Portals of Entry of the Bacteria
The time when the bacteria enter the body cannot be specifically determined, but the portals of entry of these bacteria can be identified. The first portal of entry is through the women’s reproductive system or the vagina. Women who use tampons that are not changed frequently have a high risk of acquiring the disease.
On the other hand, patients with Staphylococcus infections, such as individuals that have pneumonia or blood infection septicemia, also are at high risk of obtaining the disease. Furthermore, women who have given birth or undergone an abortion recently are also at high risk.
Lastly, like in most diseases, toxic shock syndrome can be acquired through the exposure of wounds caused by cuts or trauma to these bacteria.
Treatment of Toxic Shock Syndrome
Because the disease is fatal within hours, it is important to treat the patients immediately when the diagnosis has been made. The patient should be hospitalized and intravenous medications should be given. These medications include antibiotics that target specifically the etiologic agents. The drug that is generally prescribed by doctors is Clindamycin.
Moreover, supportive therapy is sometimes given to help the host in fighting the disease. This is comprised of giving intravenous solutions to avoid injury to the organs. When the patient is hypotensive, medicine that elevates blood pressure is taken by the patient. Sometimes, when the disease has progressed and renal damage has already been made, the patient also undergoes dialysis.
In cases when a deep wound was the port of entry of the bacteria, it is regularly and thoroughly cleaned. Lastly, when the patient experiences breathing problems, oxygen ventilation supports the patient.
The estimated time of recovery for each patient is two to three weeks.
Prevention of Toxic Shock Syndrome
For women undergoing their menstruation period, it is advisable that they use sanitary napkins instead of tampons. If they refuse to use sanitary napkins, it best to use tampons that are frequently changed. In other words, prolonged use of a single tampon is not recommended.
Utilization of vaginal sponges and diaphragms should be avoided because it makes the individual at a higher risk in developing toxic shock syndrome.
When a wound is present, it is advisable to have the area thoroughly cleaned and properly dressed.
The Centers for Disease Control and Prevention (CDC) statistically calculated that 5 to 15 per cent is the mortality rate of toxic shock syndrome. Approximately 30 to 40 per cent experience a recurrence of this disease. This is the reason why the best way to treat the disease is through early detection. It is always best to treat the disease at an early stage so its progression is halted and complications affecting the body’s systems are avoided.